Millions more Texans will have health insurance under the Affordable Care Act

The percentage of Texans with health insurance will increase to 91 percent – up from 74 percent today – after the national health care law takes effect in 2014, the state’s Medicaid director told lawmakers Monday.

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An estimated 2.3 million Texans will still lack health insurance after the Affordable Care Act takes effect, partially because undocumented immigrants are not eligible for coverage, State Medicaid Director Billy Millwee told a joint meeting of the House Public Health and Insurance committees.

Texas also has not yet developed a health insurance exchange, which the federal law created as a way to increase competition, cut costs and make buying insurance easier because residents will be able to compare insurance prices and benefits. The state has until Jan. 1, 2013 for proving a state exchange is on track.

Gov. Rick Perry opposes the exchanges because he believes the Supreme Court will find the law – the signature measure in President Barack Obama’s first year – unconstitutional.

Rep. Garnet Coleman, D-Houston, wondered what consequence will befall Texas if it refuses to create a health insurance exchange: “Do we turn into a bunny?”

“The federal government will establish an exchange in states that don’t,” answered Katrina Daniel, an associate commissioner in the Texas Department of Insurance.

Millwee said the state is prepared to implement the rules regardless of whether the high court declares them constitutional. “I think we’re going to be well-positioned, whether it’s found to be constitutional or not,” Millwee told the Associated Press.

Yes, it’s Rick Perry’s hope that the Supreme Court will allow him to go on not caring about people who don’t have health insurance or access to health care, as he always has. Some of the sillier candidates for office this year would go so far as to amend the Constitution to ensure that health care remain unaffordable and unattainable for millions of Americans. I’m still waiting for them to propose some alternate plan for accomplishing what the Affordable Care Act aims to do. Rick Perry has been Governor since the dawn of time. What has he ever done about this? What would he do if he weren’t being forced to do it? I think we know the answer to that.

Lawmakers remain concerned over how Texas will fund the expected increase in Medicaid patients. The Health and Human Services Commission predicts that by the end of 2014, Medicaid will expand from 3.5 million beneficiaries to 4.7 million. HHSC is still calculating the actual cost to taxpayers, but it could be as much as $27 billion over the first 10 years, with the federal government paying for nearly all the cost of the new law in the first two years.

What always goes unsaid is that there is a cost to not doing anything as well. It costs the taxpayers money when an uninsured person goes to the emergency room, for routine care or to treat something that has gotten worse because it wasn’t dealt with early on. It costs us all when people are forced to go to work sick, or children are forced to go to school sick. Children who don’t have access to basic health care have worse outcomes in life. Those costs are harder to quantify, but they’re there, and we’re paying for them. Spending it on Medicaid, especially in a state that stands to benefit disproportionately from federal subsidies, is a much better deal. EoW and BOR have more.